Symptomatic urolithiasis in pregnancy - urological impact and obstetric Outcome

Introduction and objectives-Urolithiasis in pregnancy presents unique management issues concerning investigation modalities, treatment of stone and overall concern over the maternal and fetal well being. A retrospective audit was performed in pregnant women presenting with symptomatic urolithiasis to study the presentation, management, and the impact on maternal and fetal wellbeing.Materials and Method-This was a retrospective analysis of pregnant women requiring urological intervention for urolithiasis, between Jan 2001-March 2012. Data was collected from the electronic medical records.Results-There were a total 18 patients, belonging to the age group between 18-33 years. 8 of them were primigravida and 10 were multigravida. Six of them were in their 1st trimester, 8 in the 2nd and 4 in the 3rd trimester. Six out of 18 patients presented with abnormal creatinine (S. creat 0.8mg ). Seventeen patients presented with colic, 3 presented with LUTS and 7 of them presented with fever of whom four had a positive urine culture and one had a positive urine and blood culture. Median duration of symptoms at presentation was 120 hours. In our series 12 out of the 18 patients required urological intervention, 4 underwent DJ stenting, 2 URS, 5 PCN and 1 cystolithotomy. Conclusions-One-third of pregnant women with symptomatic urolithiasis had an abnormal serum creatinine. Serum creatinine more than 1.4mg was associated with a poor obstetric outcome. Urological intervention was required in 12 out of 18 patients. It is important to prevent delay in referral of pregnant women presenting with symptomatic urolithiasis to an urologist.